Efficacy Analysis Of Interlocking Intramedullary Nail And Locking Plate In The Treatment Of Humeral Shaft Fracture

Objective:The interlocking intramedullary nail and locking plate were used to fix the humeral shaft fracture,and the therapeutic effect of the two was analyzed,so as to provide some reference for the clinical research and clinical work in the futureMethods:This study selected in January 2019 to June 2020 in the Qinghai university affiliated hospital of humeral fractures in 49 cases of patients,through the diagnosis of different internal fixation operation method to be divided into two groups,using a prospective,scientific research,adopt the mode of direct outpatient or telephone follow-up regular follow-up,compared two groups of patients with fracture operation situation and the main postoperative complications(including surgical wound infection,radial nerve damage and fracture healing,shoulder joint injury,etc.)analysis of the advantages and disadvantages of two types of internal fixation,to guide clinicians to choose the right means of fixed for humeral fracture,analysis of complications,And reduce the incidence of complications.Results: In the LCP group,the average duration of surgery was(122.22±24.39)minutes,the average cumulative blood loss was(151.85±40.86)ml,and the average cumulative hospital stay was(10.59±3.10)days.In the interlocking intramedullary nail group,the average duration of operation was(95.00±15.51)minutes,the average cumulative blood loss was(82.27±29.59)ml,and the average cumulative hospital stay was(9.18±2.34)days.There were significant differences between the two groups in the mean duration of operation and the mean amount of bleeding(P<0.05),and there was no statistically significant difference in the average length of hospitalization(P=0.085 >0.05).There was no case of wound bacterial infection in the two groups with internal fixation treatment.In the locking compression plate group,there were 2 cases of radial nerve injury,2 cases of fracture nonunion,and no cases of shoulder injury.In the interlocking intramedullary nail group,there was no radial nerve injury,and there was 1 case of fracture nonunion and 1 case of shoulder injury.In terms of clinical complication analysis,the results of the two internal fixation methods were not statistically significant(P>0.05).In the postoperative shoulder score,the average score of the locking compression plate group was 91.33±4.02,and the average score of the interlocking intramedullary nail group was 88.82±5.22.There was no statistical difference in the postoperative Constant score of the shoulder between the two internal fixation methods(P=0.063>0.05).Conclusion:Both interlocking intramedullary nail and locking compression plate can achieve good fixation and recovery prognosis in the treatment of humeral shaft fractures.In terms of operative duration and operative blood loss,the interlocking intramedullary bone group is significantly better than the locking compression plate group.In terms of postoperative complications,clean operation and routine use of antibiotics can significantly prevent wound infection.However,because of the large dissection of the local soft tissue around the fracture and the need to separate the periosteum,the locking compression plate has a great impact on the local blood transport microenvironment at the fracture end,and it is easy to cause compression or direct injury to the radial nerve in the process of fracture reduction and fixation.Interlocking intramedullary nail group belongs to intramedullary fixation,which is more biomechanical,but the rotator cuff needs to be opened due to the problem of surgical approach,which is easy to damage the shoulder joint.For C-type complex fractures,reaming or insertion of intramedullary nails will cause more fracture displacement and affect fracture healing,which requires re-incision for functional reduction,which also increases the operative time and difficulty.